1. Baltimore Sleep and Wellness
Center
Sleep Disordered Breathing and Obstructive Sleep Apnea
Blue Paper

2. Prevalence of Sleep Disordered Breathing
and Obstructive Sleep Apnea
• Approximately 42 million American adults have Sleep Disordered Breathing (SDB) - T.Young NEJM 1993
‣ 1 in 5 has mild Obstructive Sleep Apnea (OSA) and 1 in 15 has moderate to severe OSA.
• 9% of women and 25% men in the middle-aged working population have OSA. - Marshall Sleep 2008
‣ OSA defined as AHI ≥ 5
‣ “Middle-aged” defined as 30-60-year-olds
• ∼75% of severe SDB patients are not diagnosed - Young Sleep 2008

3. Clinical Features of Sleep Apnea
✓ Excessive daytime sleepiness ✓ Short-term memory loss
✓ Loud snoring ✓ Nocturia
✓ Witnessed apneas ✓ Atrial fibrillation
✓ Nocturnal choking and coughing ✓ Gastroesophogeal reflux disease
✓ Restless sleep/heavy sweating ✓ Arrythmias
✓ Intellectual deterioration
✓ Impotence

4. Sleep Apnea Risk Factors
✓ Obesity
✓ Anatomic abnormalities
✓ Male gender of the upper airway
✓ ✓
Increasing age Smoking
✓ ✓
Family History Endocrine and
metabolic disorders
✓ Alcohol or sedative use

5. Obesity Severity Levels
Body Mass Index
• BMI 25-29: Overweight
- 30% of children/adolescents -NCHS 1999-2002
• BMI 30-35: Obese
- 40% have OSA -Vgontzas et al. Arch Intern Med 1994
• BMI >35: Morbidly obese
- 77-98% have OSA

6. Sleep Apnea Prevalence in
Comorbidities
Percentage

7. Sleep Apnea Prevalence in
Comorbidities
Percentage

8. Sleep Apnea Prevalence in
Comorbidities
Percentage

9. Sleep Apnea Prevalence in
Comorbidities
Percentage

10. Sleep Apnea Prevalence in
Comorbidities
Percentage

11. Sleep Apnea Prevalence in
Comorbidities
Percentage

12. Sleep Apnea Prevalence in
Comorbidities
Percentage

13. Sleep Apnea Prevalence in
Comorbidities
Percentage

14. Sleep Apnea Prevalence in
Comorbidities
Percentage

15. Sleep Apnea Prevalence in
Comorbidities
Percentage

16. Untreated OSA Patients Have a Higher
Recurrance of Atrial Fibulation

17. CPAP May Improve Insulin Sensitivity